1. Field of the Invention
The present invention relates generally to cervical collars. In particular, the present invention relates to cervical collars that are capable of being independently adjusted in height and circumference, as well as independently adjustable with thoracic and occipital extensions, to accommodate unique physical attributes of the heads and necks of various individual wearers.
2. Description of the Related Art
Cervical collars have been developed to limit the range of motion of the cervical spine of an individual who has sustained trauma to the head and/or neck as a result of an accident, illness or injury. Movement of the cervical spine is designated into four specific categories: flexion (chin downward motion); extension (chin upward motion); rotation (chin left-to-right/right-to-left motion); lateral bending (ear to shoulder motion); and any combinations thereof. The primary roles of a cervical collar are to support its wearer's head in a neutral or specifically designated position relative to the wearer's neck and torso, and to restrict the wearer's movement therein. These roles are accomplished by selecting and applying a cervical collar that is appropriately measured and sized, commensurate with the unique physical attributes of the head and neck of the wearer. To ensure the cervical collar is properly sized, two physical measurements of the wearer must be considered: the height from the bottom of the chin to the top of the sternum; and the circumference of the neck at its midline. These measurements correspond to a specifically sized cervical collar. An improperly sized cervical collar may not properly support the head of its wearer, thereby allowing unwanted head movement and causing further injury.
Many cervical collars, such as those shown in U.S. Pat. Nos. 3,756,226, 5,230,698 and 6,254,560, are manufactured and commercially offered in a range of individual sizes, which combine various heights and circumferences to accommodate the unique physical attributes of a broad range of prospective wearers. Those products are typically designated as “sized” cervical collars. For example, when a healthcare provider is selecting an appropriately sized cervical collar for an adult patient, he will have to choose from amongst up to about twenty variously sized cervical collars described in U.S. Pat. No. 3,756,226, fifteen variously sized cervical collars described in U.S. Pat. No. 5,230,698, or seven variously sized cervical collars described in U.S. Pat. No. 6,254,560. Thus, to establish, maintain, and replenish a complete inventory of any of those adult cervical collars (not to mention their infant and pediatric sizes) is extremely costly. Furthermore, an excessive amount of space is necessary to store the material. In emergency transport vehicles such as ambulances, there is a minimal space allocation, and it is difficult to store all the various sizes of “sized” cervical collars. When a properly sized cervical collar is unavailable, a healthcare provider may apply an improperly sized cervical collar to a patient, thereby increasing the risk of injury. Even when a sufficient inventory of cervical collars is available, an inexperienced healthcare provider may inadvertently select the wrong size cervical collar, which also increases the patient's risk of injury.
In an attempt to overcome the above shortcomings associated with “sized” cervical collars, other manufacturers have developed cervical collars, such as those shown in U.S. Pat. Nos. 5,433,696, 7,674,234 and 7,981,068, having means for adjusting the height and circumference of the cervical collars, thereby reducing the amount of unique cervical collars required for the manufacturers' specific product lines. Those products are typically designated as “universal” cervical collars. However, in their attempt to serve as one-size-fits-all products, those cervical collars exhibit other design shortcomings which can cause a wearer injury.
For example, some universal cervical collars include components that may become lost or separated from the cervical collar, thereby rendering the cervical collar useless. U.S. Pat. No. 5,433,696, for example, describes a universal cervical collar in which the height adjustment mechanism, including a separate spacer is secured by separate tightening screws used to lock various elements to one another. Accordingly, that cervical collar requires a separate tool, such as a screwdriver, to properly lock the cervical collar into position. As a practical matter, and given the often urgent circumstances under which cervical collars must be applied, a healthcare provider will often be allowed insufficient time to assemble that cervical collar without the risk of potential failure, and future injury to the wearer.
In another example, a healthcare provider may select a cervical collar as described in U.S. Pat. No. 7,674,234. Unfortunately, as a result of its geared height adjustment mechanism, that cervical collar does not provide adequate support of the mandible throughout the height adjustment range, and thereby permits excessive lateral bending and rotational movement. Another serious consequence of that cervical collar's height adjustment mechanism is that, as height increases, the mechanism distorts the relative neutral position and places the wearer in hyper-extension, thus causing the wearer injury.
In yet another example, a healthcare provider may select a cervical collar as described in U.S. Pat. No. 7,981,068, which includes a removable height support mechanism. That mechanism is intentionally separate from the main cervical collar and requires a separate locking button to connect the mechanism to the main cervical collar. As stated in U.S. Pat. No. 7,981,068, the adjustable height support mechanism is configured to be removable from the cervical collar to allow for maintenance, or cleaning around the area. However, as with the cervical collar of U.S. Pat. No. 5,433,696, components that can be separated from the cervical collar are easily misplaced, mishandled, and often lost, rendering the cervical collar useless. When a cervical collar, such as the one described in U.S. Pat. No. 7,981,068 is applied to a patient, and a component of the cervical collar is unable to be reattached, the patient may be put at risk of serious and potentially life threatening injury. Furthermore, as with most collars the cervical collar of U.S. Pat. No. 7,981,068 relies on the wearer's shoulders for support of the cervical collar to restrict lateral movement. When the height support of that cervical collar is adjusted (i.e., the height of the cervical collar is increased), the cervical collar is caused to lift off of the shoulders of the wearer, thereby interfering with the overall support of the cervical collar and consequently resulting in unnecessary lateral movement possibly causing injury to the wearer.
The examples above indicate a need for a cervical collar that, in addition to offering multiple sizes in a single cervical collar, must be easy to use and apply to a wearer, must sufficiently maintain neutral alignment and limit the range of motion of the cervical spine, and must not require separate individual components which may become lost, thereby rendering the cervical collar useless. Furthermore, the individual height adjustment and circumference adjustment must function independently of one another to accommodate the unique physical attributes of each prospective wearer.
Another requirement of a cervical collar is that the cervical collar should not be lacking in any qualities associated with cervical spine stabilization, specifically those related to flexion and extension. Rather, the cervical collar should include features that serve to enhance the limitation of the wearer's motion.
Furthermore, due to the ever-present goal of the healthcare industry to produce low cost, high quality products, additional consideration must be given to the cost, and the difficulty, associated with manufacturing the cervical collar. Due to the complexity of their height adjustment mechanisms, many commercially offered cervical collars require numerous parts. For example, the aforementioned cervical collar described in U.S. Pat. No. 7,674,234, utilizes a variety of separately manufactured components such as pawls, rows of ratchet teeth, and a locking button sub-assembly mechanism, which substantially increases the manufacturing cost of the cervical collar. That example is indicative of the need for a single cervical collar that can accommodate a wide range of various sizes and is cost effective.
Finally, the efficacy of a cervical collar is largely attributable to wearer compliance, which requires the cervical collar to be anatomically shaped, contoured, and properly ventilated, while providing sufficient support and comfort to allow the cervical collar to maintain the wearer's head in a neutral position relative to the neck and torso, and restrict the wearer's movement.
Therefore, there is a need for a cervical collar that is capable of being independently adjusted in height and circumference to accommodate the unique physical attributes of a broad range of prospective wearers, and that includes additional features that serve to enhance the limitation of the wearers' motion. In particular, there is a need for a cervical collar that includes a frontal thoracic extender that significantly reduces flexion, and occipital and rear thoracic extenders that significantly reduce extension. These additional components should be non-removable, retractable, and independently adjustable so that the features provide the precise degree of restriction of movement deemed necessary by a healthcare provider.